Can you mix probiotics
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Can You Mix Probiotics? Analyzing the Efficacy and Safety of Probiotic Mixtures
Introduction to Probiotic Mixtures
Probiotics are live microorganisms that provide health benefits when consumed in adequate amounts. While many studies focus on single-strain probiotics, there is growing interest in the potential advantages of using mixtures of different probiotic strains. This article explores the efficacy and safety of probiotic mixtures compared to single-strain probiotics.
Efficacy of Probiotic Mixtures
Health Benefits Across Various Conditions
Research indicates that probiotic mixtures can be effective in treating a range of health conditions. These include irritable bowel syndrome, diarrhea, atopic diseases, immune function, respiratory tract infections, gut microbiota modulation, inflammatory bowel disease, and Helicobacter pylori infection1. In many cases, mixtures have shown greater efficacy than single strains, suggesting potential synergistic interactions between different probiotic species1 3.
Infantile Colic
A study on infantile colic demonstrated that a probiotic mixture significantly reduced crying time in breastfed infants compared to a placebo. The mixture also improved the quality of life for both infants and their parents, with no reported adverse effects2. This suggests that probiotic mixtures can be both effective and safe for use in infants.
Gut Microbiome Modulation
In animal studies, mixed probiotics have been shown to induce more significant and diversified changes in the gut microbiome compared to single-strain probiotics. For instance, a study on healthy rats found that mixed probiotics increased both alpha and beta diversity of the gut microbiome, indicating a more robust modulation effect3. This enhanced modulation could be due to the synergistic effects of different strains working together.
Safety and Immune Response
Immune Function and Inflammation
Probiotic mixtures have also been found to modulate immune responses effectively. For example, a study on juvenile red sea bream showed that mixed probiotics improved immune responses, antioxidant enzyme activity, and growth-related gene expression more effectively than single strains7. Similarly, in COVID-19 patients, a probiotic mixture reduced inflammatory markers and the need for oxygen support, highlighting its potential in managing inflammation8.
Prevention of Necrotizing Enterocolitis
A meta-analysis revealed that mixed probiotics significantly reduced the risk of stage II-III necrotizing enterocolitis (NEC) and mortality in premature infants, outperforming single-strain probiotics5. This finding underscores the potential life-saving benefits of using probiotic mixtures in vulnerable populations.
Comparative Efficacy: Single-Strain vs. Multi-Strain Probiotics
Disease-Specific Outcomes
While some studies suggest that multi-strain probiotics are generally more effective, the efficacy can be disease-specific. For instance, single-strain probiotics were found to be more effective for certain conditions like necrotizing enterocolitis, whereas mixtures were better for eradicating H. pylori6. Therefore, the choice between single-strain and multi-strain probiotics should be based on specific health conditions and evidence from clinical trials.
Growth and Digestive Health
In aquatic species like the Pacific white shrimp, mixed probiotics have been shown to enhance growth performance, non-specific immunity, and intestinal morphology more effectively than single strains10. This suggests that mixed probiotics can offer comprehensive benefits that single strains may not provide.
Conclusion
The evidence suggests that mixing probiotics can offer enhanced health benefits across various conditions, from gut health to immune function and inflammation. While multi-strain probiotics often show greater efficacy, the choice between single-strain and multi-strain probiotics should be guided by specific health needs and clinical evidence. Overall, probiotic mixtures appear to be a promising approach for maximizing the health benefits of probiotics.
Sources and full results
Most relevant research papers on this topic
Health benefits of probiotics: are mixtures more effective than single strains?
Probiotic mixtures show greater efficacy than single strains for a wide range of health-related outcomes, but the exact mechanism remains unclear.
Literature Review
Rigorous Journal
Highly CitedEffectiveness and Safety of a Probiotic-Mixture for the Treatment of Infantile Colic: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial with Fecal Real-Time PCR and NMR-Based Metabolomics Analysis
A probiotic-mixture appears safe and reduces inconsolable crying in exclusively breastfed infants with infantile colic, improving their quality of life.
RCT
Very Rigorous JournalTreatment with mixed probiotics induced enhanced and diversified modulation of the gut microbiome of healthy rats.
Mixed probiotics treatment significantly diversified the gut microbiome in healthy rats compared to single-strain probiotics, suggesting potential synergistic effects and personalized microbiome modulation.
Non-RCT
Animal StudyRigorous JournalEffect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double‐blind, randomized, placebo‐controlled trial
Probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) may help prevent eczema in children.
RCTHighly CitedMixed probiotics decrease the incidence of stage II-III necrotizing enterocolitis and death: A systematic review and meta-analysis.
Probiotics can significantly decrease the risk of stage II-III necrotizing enterocolitis and death in premature infants, with mixed probiotics showing better efficacy than single probiotic species.
Meta-AnalysisEfficacy of Single-Strain Probiotics Versus Multi-Strain Mixtures: Systematic Review of Strain and Disease Specificity
Single-strain probiotics are generally equivalent to multi-strain mixtures, with only a few exceptions where multi-strain mixtures are more effective than single-strain probiotics.
Systematic ReviewRigorous JournalHighly CitedEffects of Single and Mixture Probiotic Supplements on Growth, Digestive Activity, Antioxidative Status, Immune and Growth-Related Genes, and Stress Response of Juvenile Red Sea Bream (Pagrus Major)
Mix strain SF+BA (D2) and SF+BM+LP+BA (D3) are recommended for improving immune response, antioxidant enzymes, and growth-related gene expression in juvenile red sea bream.
COVID-19 Pneumonia and Gut Inflammation: The Role of a Mix of Three Probiotic Strains in Reducing Inflammatory Markers and Need for Oxygen Support
A mix of three probiotic strains significantly reduces inflammatory markers and oxygen support in patients with COVID-19 interstitial pneumonia.
RCTRigorous JournalProbiotics, Prebiotics and Immunomodulation of Gut Mucosal Defences: Homeostasis and Immunopathology
Probiotics and prebiotics, when combined, can enhance immune responses in the gut mucosa, potentially benefiting individuals with inflammatory bowel disease, colorectal cancer, and hypersensitivity.
Rigorous JournalHighly CitedEffects of dietary mixed probiotics on growth, non-specific immunity, intestinal morphology and microbiota of juvenile pacific white shrimp, Litopenaeus vannamei.
Dietary mixed probiotics significantly improve growth performance, non-specific immunity, intestinal morphology, and microbiota in juvenile Pacific white shrimp.
Highly Cited